Remedy Publications LLC.

Annals of Plastic and Reconstructive Surgery

2020 | Volume 4 | Issue 2 | Article 10531

The Utilization of a Topical Nitric Oxide Generating Serum in the Aging Skin Population: A Pilot Study

OPEN ACCESS

*Correspondence:Greg Chernoff, Director, Chernoff

Plastic Surgery, 9002 N Meridian St., Suite 205, Indianapolis, IN 46260, USA,

E-mail: greg@drchernoff.comReceived Date: 26 Mar 2020Accepted Date: 13 Mar 2020Published Date: 15 Apr 2020

Citation: Chernoff G. The Utilization of a Topical

Nitric Oxide Generating Serum in the Aging Skin Population: A Pilot Study. Ann Plast Reconstr Surg. 2020; 4(2):

1053.

Copyright © 2020 Greg Chernoff`. This is an open access article distributed

under the Creative Commons Attribution License, which permits unrestricted

use, distribution, and reproduction in any medium, provided the original work

is properly cited.

Short CommunicationPublished: 15 Apr, 2020

AbstractNitric oxide is necessary for optimal cellular health. Topical Nitric oxide can be produced without the generation of nitric dioxide. A novel nitric oxide generating serum is examined in this Pilot Study. Nitric oxide is a free radical gas, produced endogenously from arginine by nitric oxide synthetase. Nitric oxide mediates vasodilation and inhibits platelet aggregation. As a result, Nitric oxide is a potent vasodilator, and increases blood flow via capillary recruitment. Topical Nitric oxide Serum enhances the tone, quality and texture of skin, yielding a reduction in the appearance of fine lines, static rhytids, enlarged pores, and unwanted pigment. When used prior to any other product, the vasodilatory property primes the skin to enhance the absorption of other products.

Keywords: Nitric Oxide (NO); Regenerative medicine; Topical application

IntroductionThe fields of cellular medicine and regenerative therapy are growing rapidly [1]. There are tens of

thousands of papers describing the health benefits of nitric oxide [2]. NO is an important biological messenger in human physiology. NO plays a role in vasodilation [3], and inhibition of platelet aggregation and adhesion to vascular endothelium [4,5]. Skin studies show that NO is involved in the proliferation and differentiation of epidermal cells, regulation of immune and inflammatory responses, control of allergic manifestations, antigen presentation, and microbicidal activity [6,7]. NO is a key molecule in wound healing and tissue regeneration due to its gene regulatory properties, and its’ influence on the proliferation and differentiation of fibroblasts, keratinocytes, monocytes, and macrophages [8-14].

MethodsA novel “Patent Pending” NO generating dual chamber mixing serum (Pneuma Nitric Oxide,

Austin, TX) was examined for preliminary efficacy and proof of concept. Nitric oxide was detected and quantified using an ozone-based gas phase Chemiluminescent Detector (CLD); (Eco Physics, Michigan, USA). Contents of both chambers of the NO generating serum were dispensed and mixed on the skin. The CLD detector was placed one inch from the skin after the serum application. Initial nitric oxide levels reached over 15,000 ppb during the mixing period, and then demonstrated normal decay kinetics. Nitric oxide could still be detected 30 minutes after the initial application.

Twenty five patients were examined. There were 20 females and 5 males. Ages ranged from 32 years to 81 years old. Patients applied the NO serum morning and evening after washing their skin with a gentle cleanser. Follow-up was at 4 week intervals for 12 weeks. Patients were administered “Linear Analog Scales” examining wrinkles, pores, evenness, oiliness, pigment and vasculature (Figure 1). Overall satisfaction was also measured by Linear Analog scores (Figure 2). Quantification of the aforementioned features was obtained using the 3-dimentional image analysis of Life VIZ App (Quantificare, France). These results were then compared to Quantificare’s reference population database of normal aging skin, adjusted for age, sex and skin type. The 3-dimentional high resolution micro-imaging of the skin surface was taken using a micro-imaging system (Quantificare, France) (Figure 2).

Greg Chernoff* MD, FRCS(C)

Chernoff Plastic Surgery, Indianapolis, Indiana, Santa Rosa, California, USA

Figure 1: Linear analog scale.

Greg Chernoff Annals of Plastic and Reconstructive Surgery

Remedy Publications LLC. 2020 | Volume 4 | Issue 2 | Article 10532

Before NO Application After NO Application Note: Increased Vascularity

Before NO Application

Before NO Application 30 Days After NO Application

30 Days After NO Application

Figure 2: The 3-dimentional high resolution micro-imaging of the skin surface was taken using a micro-imaging system.

ResultsThere were no hypersensitivity, allergic, or irritant reactions

reported by any patient. Table 1 summarizes the linear analog scores for measured features. The results were consistently favorable with increased usage over time. Sixty-five percent of patients noticed a decrease in visible wrinkles at 4 weeks, 70% by 8 weeks, and 87% by 12 weeks. Decreased pore size was reported by 50% at 4 weeks, 61% at 8 weeks, and 65% by 12 weeks. An increase in skin tone was perceived by 70% at 4 weeks, 82% at 8 weeks, and 85% by 12 weeks. Improved skin texture was noted by 72% at 4 weeks, 81% by 8 weeks, and 88% by 12 weeks. Decreased pigmentation was noticed by 50% at 4 weeks, 62% at 8 weeks, and 75% by 12 weeks. Decreased skin oiliness was noted by 70% at 4 weeks, 75% by 8 weeks, and 83% by 12 weeks. Unwanted vasculature such as telangiectasia or rosacea-related erythema was improved in 18% of patients at 4 weeks, 32% by

8 weeks, and 51% by 12 weeks.

Table 2 summarizes patient overall satisfaction with the product. By 12 weeks, 84% of patients were “Extremely Happy” with their

Percentage

Measured Feature 4 Wks 8 Wks 12 Wks

Decreased wrinkles 65% 70% 87%

Decreased pore size 50% 61% 65%

Increased skin tone 70% 82% 85%

Improved skin texture 72% 81% 88%

Decreased pigmentation 50% 62% 75%

Decreased oiliness 70% 75% 83%

Decreased erythema 18% 32% 51%

Table 1: The linear analog scores for measured features.

Greg Chernoff Annals of Plastic and Reconstructive Surgery

Remedy Publications LLC. 2020 | Volume 4 | Issue 2 | Article 10533

results. Other patients were “Very Satisfied” or “Satisfied”. There were no “Unhappy” patients who used the product in the 4, 8, or 12 week populations.

ConclusionThis “Pilot Study” demonstrated the benefits of a topical NO

producing serum in the aging skin population. The improved circulation and pro-fibroblastic enhancing capabilities provide for aesthetic improvement when used alone, and improved absorption dynamics when combined with other products as an “absorption priming” product.

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10. Rizk M, Witte MB, Barbul A. Nitric oxide and wound healing. World J Surg. 2004;28(3):301-4.

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Percentage

Satisfaction 4 Wks 8 Wks 12 Wks

Unhappy 0 0 0

Satisfied 75 20 10

Very Satisfied 19 72 6

Extremely Happy 6 8 84

Table 2: Patient overall satisfaction with the product.